I write on behalf of the Geriatric Medicine Society of Malta, an independent NGO with geriatricians as members, about the recent document ‘National minimum standards for care homes for older people’ and the ensuing discussion on whether St Vincent de Paul should be excluded from following these regulations.

While congratulating the instigators and compilers of this document, which should finally ensure that registered care homes are of a significant standard to safeguard the quality of life of residents, the society’s committee members agree that St Vincent de Paul cannot be easily or conveniently slotted in a definition of care home. This dilemma continuously surfaced in meetings and seminars convened to discuss the proposed standards.

For the past 25 years at least, the institution has often been described as a complex since it provided a whole spectrum of services from residential to nursing to hospital care. Indeed, it is not easy to find a similar institution in other countries. For example, it is the only local long-term or chronic care facility that provides a 24-hour medical service on site led by consultant geriatricians. Many medical conditions and complications, even acute ones, are competently managed at this institution without having to transfer patients to Mater Dei Hospital.

That St Vincent de Paul, in this document, has been described as unique facility or in a class of its own (sui generis) is therefore no surprise.

However, it should still comply with standards specific to its perceived role. Recommendations can be adopted and adapted from the published document, augmented appropriately with other relevant and measurable domains.

Dignity, choice, autonomy, adequate bed space are just as important in St Vincent de Paul as in any care home but aspects of clinical care, more associated with a hospital environment, have also to be recognised and emphasised.

Such an important document on standards, so long in coming, should not generate controversy when the same goal is being pursued by all – that of ensuring an optimal quality of life for older people in any form of local institution.

If anything, all should now work together to push so that these recommended standards would become law.

Politicians, on too many occasions in the past, have hesitated on this issue at this crucial last hurdle moment. It must not be allowed to happen again.